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Advice for exercise during pregnancy has been evolving since the American College of Obstetricians and Gynaecologists (ACOG) first issued guidelines for prenatal physical activity in 1985. These guidelines were, in fact, largely based on the opinions of healthcare providers rather than scientific research or study evidence.

Over the decades, we have gathered more and more evidence offering a very different outlook from the original guidelines published in 1985. While the current recommendations continue to evolve, there is no question that keeping fit and active during pregnancy is terrific for both the mother and the unborn baby!

What Exercises Are Safe?

Almost all types of exercise are actually safe in pregnancy. Exercise does not harm the developing baby when performed within safe levels.

The Australian Department of Health recommends that pregnant women aim for 150–300 minutes of moderate-intensity physical activity per week or 90–150 minutes of vigorous-intensity physical activity per week. These activities include, but are not limited to, walking, jogging, swimming, cycling, and Pilates. There is strong scientific evidence that moderate-intensity exercise is safe and does not elevate the risk of low birth weight, preterm delivery, or early pregnancy loss.

Muscle strengthening activities are recommended at least twice each week. In addition, pelvic floor exercises must be completed to help strengthen and improve pelvic floor muscle function, which provides perineal support for the pelvic structures.

Activities Requiring Caution

Some activities fall under the category of weighing pros vs. cons and should be adapted appropriately after discussing with your doctor or allied health practitioner, such as an Exercise Physiologist or Women’s Physiotherapist. These include:

• Sports with a high risk of impact or trauma, such as contact sports
• High-impact exercises involving jumping, twisting, sudden movements, or bouncing, which may strain the abdomen or pelvic floor
• Activities with a higher risk of falling, such as skiing, mountain biking, and horseback riding
• Lying flat on your back during exercise after the first trimester

Activities to Avoid

Some activities must be strictly avoided during pregnancy, including:

• Scuba diving
• Skydiving
• High-altitude training
• Hot yoga or hot Pilates

How to Train Safely

“Listen to your body” is advice almost every pregnant woman has received at least once during their pregnancy. However, they have never actually been taught what it means to listen to their body. Without that lesson, this advice isn’t very helpful!

Adjust Training

The physiological and physical changes that occur during pregnancy affect each woman differently. As pregnancy advances through the trimesters, you will need to adjust your training for various factors such as nausea, changing mood and energy levels, weight gain, changed posture, and water retention. While some women may be able to continue with certain exercises longer, some may need to stop certain movements earlier than others.

If you want to maintain an active lifestyle during pregnancy, you may wonder how to keep exercising safely with all these rapid changes. There are exercises and strategies that can make pregnancy more comfortable, delivery a little easier, and postpartum recovery faster. Let’s dive into some general guidelines to modify training for each trimester.

First Trimester

Early weeks of pregnancy bring fatigue and nausea. Hormone and energy levels are changing, and you will probably need to slow down more than you’d like. Be patient with yourself as you begin to adjust to your changing body. These changes could look like:

• Decreased workout volume and increased rest time between sessions to allow for more recovery
• Limiting max effort lifts: strength training through pregnancy follows a bell curve. In the first trimester, you may not be able to tolerate much load. In the second trimester, you may be able to increase your load with an influx of new energy, and in the third trimester, you may need to take it back down to avoid overstressing your body before birth.
• Building awareness of pelvic floor and core connection through specific exercises

Second Trimester

Your workouts will need to accommodate your growing belly. Some important adjustments in the second trimester may include:

• Modifying or reducing high-impact exercises such as jump ropes, box jumps, and running
• Modifying exercises that require lying flat on your back
• Modifying core-focussed exercises that can increase strain on your abdomen or pelvic floor muscles
• Adjusting load: It is important to understand that just because your body can lift a certain load, placing excessive strain on the pelvic floor may do more harm than good.
• Avoiding exercises that increase heaviness in the pelvic floor

Third Trimester

By this point, you may feel very sluggish and very pregnant. Stay active in ways that you can, steadily reducing workout intensity, load, and frequency. Some important adjustments that you may need to make include:

• Incorporating pelvic floor and birth prep exercises
• Specific lower limb exercise adjustments if you are experiencing lower back, sacroiliac joint, or hip pain
• Modifying exercises that require lying flat on your back
• Modifying exercises to maintain steady balance and minimize the risk of falls
• Continuing to reduce load
• Training breathing to manage intra-abdominal pressure

The best thing is that it is safe to start your active journey even if you were not very active prior. Be sure to start slowly to establish a foundation and build gradually.

Prioritize Rest and Recovery

Schedule rest days between workouts to allow the body to recover, prevent overexertion, and promote better energy management. Rest should also be prioritized on days when pregnancy symptoms like nausea, swelling, or back pain are particularly pronounced. Pushing through these signs can lead to exhaustion or worse—an injury.

Know When to Stop

If you experience any of the following symptoms, stop exercising and consult your healthcare provider:

• Dizziness or fainting
• Breathlessness at rest
• Chest pain or palpitations
• Severe headaches
• Calf pain or swelling
• Vaginal bleeding or fluid leakage
• Uterine contractions or cramping
• Pelvic pain
• Blurry vision
• Extreme fatigue or weakness

Some women can return to exercise at adjusted levels with the presence of these symptoms, while others may be advised to stop completely to ensure the safety of both the mother and baby.

Nutrition and Hydration

Good nutrition and hydration are essential during pregnancy to support the health of both the exercising mum and the growing baby. Proper hydration helps maintain amniotic fluid levels, supports digestion, and ensures the body functions optimally, preventing issues like dehydration, constipation, and swelling.

Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats helps regulate maternal energy levels, supports a healthy pregnancy weight, and reduces the risk of complications like gestational diabetes.